One Month Later: What America Has Found in

Democrats’ Government Takeover of Health Care

“We have to pass the bill so that you can find out what is in it.”

— Speaker Nancy Pelosi, March 2010 i

Speaker Pelosi claimed that Democrats needed to pass their government takeover of health care so that
the American people could find out its benefits “away from the fog of the controversy.” ii But one month
after President Obama signed the measure into law (P.L. 111-148), iii the American people have found
new problems in the Democrat approach—leading to further declines in the overhaul’s popularity:

Costs Will Go Up. The Centers for Medicare and Medicaid Services released its analysis of the health
and reconciliation laws, which found that the legislation will increase health costs, not contain them. iv
The actuaries also asserted that health care shortages and price increases “should be considered plausible
and even probable” after the law’s enactment, that many provisions in the legislation intended to control
health costs will have a “negligible financial impact,” and that some of the major savings projections in
the legislation are “unrealistic” and “difficult to attain.” v

Millions Forced to Buy Insurance. A study by Administration advisor Jonathan Gruber vi found that
more than 20 million people will obtain health coverage, not because they need it, want it, or find it
valuable—but solely because the federal government is forcing them to buy it, and taxing them if they
do not. vii The Congressional Budget Office found that the tax penalty imposed under the law for the
millions expected to violate the individual mandate will average nearly $1,000—and that more than
three-quarters of those subject to the individual mandate tax will have incomes of under $250,000,
breaking one of candidate Obama’s key campaign promises. viii

Millions Forced Out of Their Current Insurance. Earlier this month, the Administration released the
2011 payment rates for Medicare Advantage plans, reflecting the more than $202 billion in cuts to the
program scheduled to take place over the next decade. ix The cuts scheduled to take effect beginning
next year will begin a process that will see nearly five million fewer seniors in Medicare Advantage
plans, and millions more losing extra benefits that they currently enjoy. x

Rationing With Open Eyes. Earlier this week, President Obama nominated Donald Berwick to head
the Centers for Medicare and Medicaid Services. Berwick has previously indicated his support for
federal restrictions on medical treatments that are too costly. He has noted that since “we have a limited
resource pool…the decision is not whether or not we will ration care—the decision is whether we will
ration with our eyes open.” xi These kinds of statements—supporting policies that could limit access to
life-saving treatments for Medicare beneficiaries—suggest one way the Administration intends to cut
costs to fund its $2.6 trillion health care expansion.

April 26, 2010

Democrats Don’t Understand the Bill. A New York Times article, entitled “Baffled by Health Plan?
So Are Some Lawmakers,” highlighted the confusion surrounding one provision in the law requiring
Members of Congress and their staff to give up their current coverage and join the new government-run
exchanges. A Congressional Research Service report cited in the article “found that this provision was
written in an imprecise, confusing way, so it is not clear when it takes effect.” xii As one Member of
Congress observed, “If Members of Congress cannot explain how it’s going to work for them and their
staff, how will they explain it to the rest of America?”xiii

Unpopularity Grows. Even the Administration now admits the President’s government takeover of
health care defied the public will; “White House advisors said their own polling showed the health care
plan was still unpopular.” xiv And an Associated Press survey indicated that opposition to the health law
has grown since its enactment. Disapproval of the President’s handling of health care jumped six points
within a month, to “a level not seen since last summer’s angry town hall meetings.” xv

A Taxpayer-Funded Propaganda Campaign. Because of the bill’s widespread unpopularity, the

Washington Post reported that the Administration “would soon be hiring a ‘very senior official’ whose
sole portfolio would be to sell their health care overhaul to the public in the months leading up to the
Nov. 2 elections.” xvi Shortly thereafter, the Administration also unveiled an initiative to mail out “more
than 4 million” postcards to small businesses touting the tax credits in the legislation. xvii However, a
White House aide admitted that “the outreach is going to vary depending on what the provision is.”
Translation: The Administration is unlikely to put much effort into informing individuals that their taxes
will be going up, or giving seniors the details of the cuts to Medicare Advantage that will result in
millions losing extra benefits or access to their current plan. xviii

In one short month, the American people have found out about many elements of the bill. Given these
revelations, many may wonder how the reality of this brave new health care world in any way resembles
the rhetoric of President Obama and the majority.
i
Available at http://www.youtube.com/watch?v=hV-05TLiiLU&feature=related
ii
Ibid
iii
Senate-passed bill (H.R. 3590) text available at http://www.opencongress.org/bill/111-h3590/text; reconciliation bill (H.R.
4872) text available at http://www.opencongress.org/bill/111-h4872/text.
iv
Richard Foster, Department of Health and Human Services, Estimated Financial Effects of the “Patient Protection and
Affordable Care Act,” as amended, April 22, 2010,
http://republicans.waysandmeans.house.gov/UploadedFiles/OACT_Memorandum_on_Financial_Impact_of_PPACA_as_Ena
cted.pdf
v
Ibid
vi
Gruber has received two no-bid government contracts totaling nearly $400,000 to consult with the Department of Health
and Human Services on “national health care reform.” Detailed information available at
http://www.usaspending.gov/fpds/fpds.php?parent_id=355297&sortby=u&reptype=r&database=fpds&fiscal_year=2009&det
ail=4&datype=T&submit=GO
vii
“Why We Need the Individual Mandate” by Jonathan Gruber, Center for American Progress paper, April 8, 2010,
http://www.americanprogress.org/issues/2010/04/pdf/individual_mandate.pdf
viii
Congressional Budget Office, estimated distribution of individual mandate penalties under P.L. 111-148 and P.L. 111-152,
April 22, 2010, https://www.cbo.gov/ftpdocs/113xx/doc11379/Individual_Mandate_Penalties-04-22.pdf
ix
Congressional Budget Office analysis of H.R. 4872 in concert with H.R. 3590, March 20, 2010,
http://cbo.gov/ftpdocs/113xx/doc11379/Manager%27sAmendmenttoReconciliationProposal.pdf
x
Congressional Budget Office analysis of Medicare Advantage provisions in H.R. 4872 in concert with H.R. 3590, March
19, 2010
xi
“Rethinking Comparative Effectiveness Research,” An Interview with Dr. Donald Berwick, Biotechnology Healthcare June
2009, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799075/pdf/bth06_2p035.pdf
xii
“Baffled by Health Plan? So Are Some Lawmakers” by Robert Pear, New York Times April 13, 2010,
http://www.nytimes.com/2010/04/13/us/politics/13health.html
xiii
Ibid
xiv
“Democratic Party Plans Unprecedented Aid for Congressional Campaigns” by Paul Kane and Chris Cillizza, Washington
Post April 17, 2010, http://www.washingtonpost.com/wp-dyn/content/article/2010/04/16/AR2010041602567_pf.html
xv
“AP-GfK Poll: Jump in Opposition to Health Care Law” by Ricardo Alonso-Zaldivar, April 15, 2010,
http://www.google.com/hostednews/ap/article/ALeqM5i2BvA7d42vZVYA6HxwXp4Si6XYdgD9F3BKFO1
xvi
Ibid
xvii
“For Small Businesses, Health Care Pitch Is in the Mail” by George Condon, CongressDaily AM April 20, 2010,
http://www.nationaljournal.com/congressdaily/wha_20100420_8630.php
xviii
Ibid